Provider Demographics
NPI:1861935900
Name:CAMPO, VANESSA ISABEL (LPC)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:ISABEL
Last Name:CAMPO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2560
Mailing Address - Country:US
Mailing Address - Phone:973-264-9594
Mailing Address - Fax:
Practice Address - Street 1:180 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2560
Practice Address - Country:US
Practice Address - Phone:973-264-9594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ944360101Y00000X
NJ37PC01031100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor